Thursday, January 08, 2009

C-section study

This is interesting.

I am bothered by this...
The study only looked at live births, and didn't account for the small risk of the fetus dying while waiting to reach 39 weeks, Greene said. That risk has been estimated up to 1 in 1,000, he said.


Aurelia said...

Yeah, but I'm not that concerned about that because these were low risk births and the sections were all being done by choice, as electives. And women like you and I would not have been in that category.

It doesn't say never do a c-section, it just means Doctors should be cautious about doing them for strictly convenience reasons.

(I actually know several women in real life whose only reason for a c-section was to preserve the size and shape of their vagina... Maybe this study will give the docs a reason to say no to them.)

DD said...

Before the big bruhaha this past year or so, doctors were performing C-sections at 38 weeks. When I got pregnant, it was just coming down the tubes that it was highly frowned upon to do them before 39 weeks.

The reason 38 weeks can be problematic is because a majority of women DON'T KNOW WHEN THEY CONCEIVED. So if they were on the short side, babies were being delivered prematurely, whether it was out of "convenience" or "prior".

For us, we were able to go 38 1/2 wks prior to my c-section because there was no doubt that my pregnancy was indeed 38 weeks gestation.

Yes, the quote you provided is upsetting, it's a horrible number because again, maybe that baby was actually 40 wks, truly due, but it was too much stress for baby.

That's why it'd be really "convenient" if women would just get pregnant via IUI or IVF. (insert LOTS of sarcasm)

Julia said...

There is a reason why they couldn't include those cases statistically. These were all repeat c-sections, and were supposed to be low-risk. They excluded the c-sections that were done early for a medical reason. So essentially they were looking at women who were going to do either a VBAC or a repeat C. And their outcomes were those that follow a live birth, so including the babies who died before 39 weeks would've been a confounding rather than clarifying. I guess I am trying to say that if these stillbirths could've been prevented by closer monitoring, then that's the issue of how well pregnancies should be monitored in which cases rather than when uncomplicated repeat C-section pregnancies need to be delivered. Does that make sense?

And ahem... I happen to know how do I say?... a little about Dr. Greene's practice, and can report that at least one of his partners had been very conscientious about waiting until 39 weeks even prior to this paper.

kate said...

The bothersome thing to me is that the number 'up to 1 in 1000' is very off. No, ok, it is reasonable for what he is saying -- the risk of the baby dying in the 7 days between 38 and 39 weeks. But that is not how most people will read this statement, they will read it as 'the risk of the fetus dying before 39 weeks', which is (as we all know) MUCH higher than that. That is how i read it the first 3 times.